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2 <br />The signature(s) of all property owner(s), or Attorney for all property owner(s) <br />Signed: <br />Signed: <br />~12t1o <br />Address: 52447 Portage Road, South Bend, Indiana 46628 <br />Phone Number: (574) 273-4551 <br />Name, Address & Phone Number of Contact Person/Preparer (Please print): <br />Danch, Harner & Associates, Inc. <br />2422 Viridian Drive, Suite 201 <br />South Bend, Indiana 46628 <br />(574) 234-4003. <br />Fi[e~ i~ Cl~r~~ ~ ®~ft~~ <br />J~~~~ ~ ~ ~00~ <br />